The Natural and Surgically Modified History of Anomalous Pulmonary Veins From the Left Lung

摘要: Background Reconstruction of anomalous left pulmonary veins (ALPV) requires an anastomosis at a nonanatomic position, posing the potential risk vein obstruction (PVO). Methods The 514 patients who were diagnosed with abnormality from 1990 to 2010 reviewed. Thirty-eight (7.4%; median age, 1.4 years; interquartile range, 0.1 5.7 years) identified. ALPV was as isolated anomaly in 23 (61%) or part mixed total venous drainage 15 (39%). Patients divided into 3 groups (group 1: partial ALPV, treated; group 2: 3: untreated). Freedom poor clinical (death/reoperation) and functional (any PVO, mean pressure gradient > mm Hg) outcomes analyzed. Results Repair 30 (79%) performed direct atrium (n = 26 [68%]) by sutureless repair 4 [11%]). Two deaths occurred 2 (heart failure PVO). 4 reoperations prompted PVO within 6 months initial repair. There nonsignificant trend lower freedom 2 (74.6%) vs 1 (100%) 10 years ( p  = 0.105). no difference incidence any among 0.381). Severe did not develop 8 [21%]). Conclusions Total carries high early PVO. Thus, optimal surgical approach remains elusive. Untreated remained unobstructed during midterm follow-up. Therefore, treatment may be necessary ALPV.